Provider Demographics
NPI:1043769250
Name:EHR RENEWAL
Entity Type:Organization
Organization Name:EHR RENEWAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:BORGE
Authorized Official - Suffix:
Authorized Official - Credentials:BSCS, PMP
Authorized Official - Phone:612-210-0377
Mailing Address - Street 1:2326 SILVER LN
Mailing Address - Street 2:201
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-7449
Mailing Address - Country:US
Mailing Address - Phone:612-210-0377
Mailing Address - Fax:
Practice Address - Street 1:2326 SILVER LN
Practice Address - Street 2:201
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-7449
Practice Address - Country:US
Practice Address - Phone:612-210-0377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment